术中超声辅助定位在后腹腔镜肾部分切除术的应用体会  

The application of intraoperative ultrasound assisted localization in retroperitoneal laparoscopic partial nephrectomy

作　　者：陈庆科[1] 刘久敏[1] 杨浣情[1] 冼志勇[1] 陈汉忠[1] 叶楚津[1] CHEN Qing-ke LIU Jiu-min YANG Huan-qing XIAN Zhi-yong CHEN Han- zhong YE Chu-jin.(Department of Urology, Guangdong General Hospital, Guangdong Acade- my of Medical Sciences, Guangzhou 510080, China)

机构地区：[1]广东省人民医院广东省医学科学院泌尿外科,广州510080

出　　处：《现代泌尿生殖肿瘤杂志》2016年第5期264-267,共4页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨术中超声辅助定位在后腹腔镜肾部分切除术中的作用。方法回顾性总结2014年1月至2016年2月期间我们进行的后腹腔镜下肾部分切除术45例,术中先用超声刀在肿瘤区域预标记切缘为A线,后经Trocar置入腔镜B超探头,行肿瘤区域扫描明确定位为B线,比较术中A线、B线的重叠情况,以两线最大差距≥2mm为有差异,<2mm为重叠。按R.E.N.A.L.评分系统的5类进行独立评估分析。结果术中超声辅助定位能在后腹腔镜下明确瘤体生长姿势、边界及血供情况,引导切割方向以保证肿瘤包膜完整性,尤其在完全性内生肿瘤方面发挥更大的辅助效果。结论术中超声辅助定位在后腹腔镜肾部分切除术中具有较高的安全性,手术辅助效果明显。Objective To investigate the effect of intraoperative ultrasound assisted localiza- tion in retroperitoneal laparoscopic partial nephrectomy （RLPN）. Methods From January 2014 to February 2016, 45 cases with renal tumor received RLPN were analyzed retrospectively. Intraopera- tion, we first labeled margin A aroud the tumor region with harmonic scalpel, then put the endo- scopic ultrasound probe inside and scanned, and labeled the margin B as above. We compared A and B to assessment whether they were overlap or not. We difined the gap between A and B that more than or equal to 2 mm is difference, and less than 2 mm is overlap. Independent evaluation the 5 cat- egories according to the R.E.N.A.L.scoring system. Results Intraoperative ultrasound assisted lo- calization could comfirm tumor＇s growth posture, boundary and tumor angiogenesis in RLPN, guid- ing the cutting direction in order to ensure the integrity of tumor capsule, especially play a greater benefit in complete endophytic renal tumors. Conclusions Intraoperative ultrasound assisted local- ization in retroperitoneal laparoscopic partial nephrectomy is safe and effective.

关 键 词：肾部分切除术 术中超声 

分 类 号：R737.11[医药卫生—肿瘤]